BankerGirl

If it is from the same supplier we use and packed appropriately, I have no problem accepting the blood into our inventory.  I contact the transferring facility for a transfer form if they did not pack one.  

I just answered this question.

My Score PASS  

Very proud to have received this through the post earlier this week, to go with being elected to Fellowship of the British Blood Transfusion Society earlier this year.

Thank you Baby Banker.  I always wondered but never took the time to investigate.

I realize what you say is correct Malcolm, but that is what my supervisor called it and that is the way it was reported back in then.

I realize what you say is correct Malcolm, but that is what my supervisor called it and that is the way it was reported back in then.

I don't see why you'd reject a sample just for not being full, that seems a bit unnecessary. QNS or a short sample, obviously, but most patients come through for their T/S, the screen is negative, and that's it.  If you had to wait for a new sample, their old sample could have been done by then. Additionally, calling for "fuller tubes" isn't really the way to ensure higher quality in patient care. 
Overall, not worth the effort. The care teams on the floor are already quite unhappy when they have to redraw for other reasons, I can't imagine what they'd say if I called requiring a completely full sample! Their fragile stick patients may not be happy either...

We accept them as long as they don't have a really nasty antibody history (Warm or multiple antibodies) since we perform electronic XMs.  Sometimes we have to get samples redrawn due to unexpected issues, but that is the exception, not the norm, so we try to work with what we get if possible.

The other thing you have to remember is that the charges are not for the blood itself, but for the processing needed to provide the blood.  These charges are the same regardless of how much of the unit is actually administered.

ARC (American Red Cross) has issued a statement that almost 5,000 blood drives were canceled and a few hundred donation sites due to quarantines. They're trying to get people to start donating at hospitals and other "essential" sites.
The physicians have ramped up elective surgery instead of delaying them. I think it's super selfish to waste blood products during a crisis of this nature when you don't know what the outcome will be or how long the quarantines will last, it's beyond frustrating.

Platelets are in adequate supply largely due to hospitals (in my service area) enforcing restrictive transfusion measures and postponing elective surgeries. Most blood centers except in New York, Washington state, and California are treading water with respect to RBCs. As usual Rh neg units are in short supply. 
 
Most of the hospitals in my service area are also freeing up beds to treat respiratory infections. These will require fewer transfusions, although patients needing ECMO are of concern. 
 
Looking ahead, it is difficult to predict what will happen.  This is a long term event. My current concern is that blood donors will be fatigued 3 weeks from now and avoid giving blood. That is what happened after 9/11. It could be that you might need that unit of O neg on your shelf 42 days from now. 
 
In my opinion the goal is to provide blood for everyone who needs blood. Measures to restrict are prudent (and the literature indicates this is good medicine).  After this is all over and we are criticized for being too conservative, but no one died for lack of blood, I can live with that. 

I just answered this question.


My Score PASS  

We just did a history conversion from Meditech 5.67 to Meditech Expanse.  I chose 10% as my target and used a random number generator to blindly select the records to validate.  I also made sure to add a few patients that I knew had antibodies and special requirements, but found several just using the generated numbers.  Have fun!

We also use the electronic alarm functions on our equipment, and at our last assessment the inspector brought up the chart pen moving.  She told me the purpose of the alarm checks is to make sure the pen moves.  I disagreed with her, said the purpose of the alarm checks is to ensure that the alarm is activated, and we check the movement of the pen each day when we do our temperature checks.  She thought about it for a while and ended up not citing us for this.  I know there are facilities who have abandoned their graphs for centralized electronic monitoring, so I don't see how they can require that a pen move when these sites do not even have pens or graphs.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

I wondered if you were testing fecal occult blood.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

We had a patient that seemingly converted from A Positive to A Negative.  We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens.  I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

This case worries me.
The screening cells in the UK also do not have to express the Cw antigen, and yet there are several examples of anti-Cw appearing in the literature where the antibody is blamed for severe (and, in at least one, if not two, fatal) HDFN.
Those mentioned by Geoff Daniels (in Daniels G.  Human Blood Groups.  3rd edition, 2013, Wiley-Blackwell) include:
Lawler SD, van Loghem JJ.  The Rhesus antigen Cw causing haemolytic disease of the newborn.  Lancet 1947; ii: 545-546.
Kollamparambil TG, Jani BR, Aldouri M, Soe A, Ducker DA.  Anti-Cw alloimmunization presenting as hydrops fetalis.  Acta Pediatrica 2005; 94: 499-507.
Byers BD, Gordon MC, Higby K.  Severe hemolytic disease of the newborn due to anti-Cw.  Obstet Gynecol 2005; 106: 1180-1182.
May-Wewers J, Kaiser JR, Moore EK, Blackell DP.  Severe neonatal hemolysis due to a maternal antibody to the low frequency Rh antigen Cw.  Am J Perinat 2006; 23: 213-217.
Chu H-P, Kanagalingam D, Chan DKL.  Severe intrauterine hemolysis due to anti-Cw.   Am J Perinatol 2007; 24: 623-626.
A further case is Macher S, Wagner T, Rosskopf K, Reiterer F, Csapo B, Schlenke P, Klaritsch P.  Severe case of fetal hemolytic disease caused by anti-Cw requiring serial intrauterine transfusions complicated by pancytopenia and cholestasis.  Transfusion 2016; 56(1): 80-83.
I would, therefore, be far happier if the Cw antigen were expressed on both UK and US screening cells (as I believe it is in Finland and Latvia).
 

bevydawn1,  Here is the rule I had in 5.67.  Hopefully it helps.  The Data Flds From is BSP.
(([f bsp ctime]-2400)/100)^X,
(72-X)^Y,
[f bsp exp hrs set](Y);

Thanks Malcolm. I don't know why but f has always confused me way more than it should and now that manufacturer's have taken it off the panel antigrams it becomes an enigma that I have to try to explain to techs with less experience than I .....

And to give credit where credit is due, whatever I have achieved has been with the invaluable contributions of my collaborators, including physicians, scientists, medical technologists and nurses.  In particular, my most important collaborator has been my wife, Dr. Joanna Heal MBBS, MRCP, whose brilliance and dedication to patient care made all the difference. That's her in the picture :).